Provider Demographics
NPI:1265485296
Name:GRENIER, PATRICIA A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:GRENIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-7600
Mailing Address - Country:US
Mailing Address - Phone:207-873-1013
Mailing Address - Fax:
Practice Address - Street 1:88 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6665
Practice Address - Country:US
Practice Address - Phone:207-873-1013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC12471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5438255OtherAETNA
ME13014OtherCIGNA
ME004934OtherPACIFICARE
ME109929OtherMAGELLAN
ME112633OtherBEHAVIORAL HEALTH NETWORK
ME87726OtherUNITED BEHAVIORAL HEALTH
ME017348OtherANTHEM
ME109929OtherMAGELLAN